Synflorix is being offered at a 90% discount through a financing mechanism called the Advanced Market Commitment (AMC), designed to bring cut-rate vaccines to children in poor countries.

The pneumococcal bacterium (Streptococcus pneumoniae, pictured) causes diseases such as pneumonia, meningitis, and bacteremia (bacteria in blood), along with ear infections and bronchitis. Each year, these infections kill nearly one million children under 5. More than 70% are in developing countries.

Synflorix provides protection against 10 strains of S. pneumoniae. Nicaragua began vaccinating late last year. Guyana, Sierra Leone, and Yemen will as well. More than 40 developing countries will likely receive pneumococcal vaccines through AMC by 2015.

By guaranteeing the availability of initial purchase funds, AMC enables vaccine makers to invest in development and manufacturing [news release], and by contracting significant volumes over the long-term, manufacturers reduce the cost of their vaccines.

Synflorix received authorization from the European Commission in 2009. There’s usually a lag of nearly two decades before vaccines available to rich nations are made accessible to poor countries.

Across the developing world, this vaccine will have a ceiling price of $3.50 per dose, compared to the US price of close to $100. Nature reports:

Much of the small cost of the vaccine in developing countries will also be absorbed by the GAVI Alliance, explains Marina Krawczyk, who heads the AMC project for GAVI. "Right now most governments are paying around 15–30 cents per dose, but that will increase over time," she says.

At the end of the chain, the price for the end users is zero, says Shahnaaz Sharif, Kenya's director of public health and sanitation. "The Kenyan government is providing the vaccine free of charge at all public and private health facilities across the country."

Four companies have signed up with AMC so far. Last March, GlaxoSmithKline and Pfizer committed to 30 million doses each of their pneumococcal vaccines per year for the next 10 years. GSK has invested more than $400 million in a plant to manufacture Synflorix in Singapore to meet expected global demand. The Serum Institute and Panacea Biotec, both based in India, have also registered to provide the vaccine.

The AMC is backed by the World Health Organization, UNICEF, the Bill & Melinda Gates Foundation, and 5 donor countries: UK, Canada, Russia, Norway, and Italy.

Janet Fang has written for Nature, Discover and the Point Reyes Light. She is currently a lab technician at Lamont-Doherty Earth Observatory. She holds degrees from the University of California, Berkeley and Columbia University. She is based in New York.
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